Articles: back-pain.
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Review Meta Analysis
Cost-effectiveness of Acupuncture for Chronic Nonspecific Low Back Pain.
Cost-effectiveness is a major criterion underpinning decisions in mainstream health care. Acupuncture is increasingly used in patients with chronic lower back pain (LBP), but there is a lack of evidence on cost-effectiveness. The objective of this study was to assess the cost-effectiveness of acupuncture in alleviating chronic LBP either alone or in conjunction with standard care compared with patients receiving routine care, and/or sham. ⋯ When comorbid depression is alleviated at the same rate as pain, cost is around $18,960 per DALY avoided. Acupuncture as a substitute for standard care was not found to be cost-effective unless comorbid depression was included. According to the WHO cost-effectiveness threshold values, acupuncture is a cost-effective treatment strategy in patients with chronic LBP.
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Controlled Clinical Trial
Can we improve cognitive-behavioral therapy for chronic back pain treatment engagement and adherence? A controlled trial of tailored versus standard therapy.
This study evaluated whether tailored cognitive-behavioral therapy (TCBT) that incorporated preferences for learning specific cognitive and/or behavioral skills and used motivational enhancement strategies would improve treatment engagement and participation compared with standard CBT (SCBT). We hypothesized that participants receiving TCBT would show a lower dropout rate, attend more sessions, and report more frequent intersession pain coping skill practice than those receiving SCBT. We also hypothesized that indices of engagement and adherence would correlate with pre- to posttreatment changes in outcome factors. ⋯ Participants in this study evidenced a high degree of participation and adherence, but treatment tailored to take into account participant preferences, and that employed motivational enhancement strategies, failed to increase treatment participation over and above SCBT for chronic back pain. Evidence that participation and adherence were associated with positive outcomes supports continued clinical and research efforts focusing on these therapeutic processes.
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To examine whether there are differences between non-trauma-exposed, trauma-exposed without posttraumatic stress symptoms (PSS), and trauma-exposed with PSS chronic musculoskeletal pain patients in vulnerability, protective, and pain-adjustment variables; to test the interactive relationship between PSS and the vulnerability and protective psychological variables across pain adjustment in the group of trauma-exposed-patients. ⋯ The current study supports the models of posttraumatic stress and chronic pain, such as the mutual maintenance and the shared vulnerability theories, providing an initial comprehensive framework for understanding the comorbidity of both disorders.
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Randomized Controlled Trial Comparative Study
Tomography-guided palisade sacroiliac joint radiofrequency neurotomy versus celecoxib for ankylosing spondylitis: a open-label, randomized, and controlled trial.
Sacroiliac joint (SIJ) pain is a common symptom in ankylosing spondylitis (AS). Palisade sacroiliac joint radiofrequency neurotomy (PSRN) is a novel treatment for the SIJ pain. In the current clinical trial, we treated AS patients with significant SIJ pain using PSRN under computed tomography guidance and compared the results with the celecoxib treatment. ⋯ Gastrointestional irritation was more frequent in the celecoxib arm than in the PSRN arm (P < 0.05). No severe complications were noted in either arm. PSRN is both efficacious and safe in managing SIJ pain in patients with AS.
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The aim of this study was to determine the prevalence and symptoms of dysmenorrhea, its relevant factors, and the rate of seeking medical help in a group of nursing students. A total of 380 students were included in the study. The demographic data questionnaire, a Daily Menstrual Symptom Rating Scale (DMSR), and the Visual Analog Scale for pain (VASP) were used as tools for data collection. ⋯ Although dysmenorrhea is a gynecological problem that is commonly seen in young women and that negatively affects daily activities and school life, the rate of seeking medical help is low. Adolescents should, therefore, be educated and counseled to determine the underlying cause and to increase the use of an effective treatment method. Considering that nurses should be better informed about dysmenorrhea causes and treatment options, a study of nursing students was undertaken.